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Autumn 1982

Thatcher Cabinet's private consideration of radical reform of the NHS

As the prime minister offered public reassurance that the NHS was safe, the Cabinet considered introducing private health insurance and increasing user charges.

6 October 1983

Griffiths report on management in the NHS

The report of the NHS management inquiry team, led by Sir Roy Griffiths, resulted in the introduction of general management in the NHS.


Academics' development of the idea of GP fundholding

Academics and system leaders discussed the possibility of a primary health care unit being the budget holder for primary and secondary care.

12 July 1984

Health and Social Security Act 1984

The Act made family practitioner committees (FPCs) directly accountable to the Secretary of State for Health.

4 October 1985

Arguments for an internal market model

Alain Enthoven argued that an internal market model would offer substantial improvements over the existing NHS structures, where referrals were not tied to payment.

21 April 1986

'Primary health care: an agenda for discussion' green paper

The government proposed financial incentives for GPs to improve primary care.

25 January 1988

Thatcher's announcement on review of the NHS

The review produced policy ideas including creation of an internal market and GP fundholding. This formed the basis of the 'Working for patients' white paper.

31 January 1989

'Working for patients' white paper

The white paper proposed significant reforms to the NHS. It introduced a split between the bodies who provided care and those who purchased it, creating an internal market in the NHS.

29 June 1989

'Self-governing hospitals: an initial guide'

The government provided additional detail on the implementation of self-governing hospitals as outlined in the 'Working for patients' white paper.